前列腺癌风险计算器在双参数MRI诊断临床显著性前列腺癌中的价值

Value of prostate cancer risk calculator in the diagnosis of clinically significant prostate cancer using bi-parameter magnetic resonance imaging

目的探讨前列腺癌(PCa)风险计算器在双参数MRI(BpMRI)诊断临床显著性前列腺癌(CsPCa)中的价值。方法回顾性分析2014年1月至2022年12月首都医科大学电力教学医院泌尿外科收治的114例前列腺疾病患者的临床、病理及多参数MRI(MpMRI)影像资料,两名放射科医师首先基于前列腺影像报告与数据系统(PI-RSAD)v2.1评分标准按照MpMRI及BpMRI评分方案对磁共振检查图像进行评分,之后基于简化版前列腺影像报告与数据系统(S-PI-RADS)评分标准的BpMRI方案进行评分。将3种方案的评分结果纳入风险计算器计算相应的概率作为另外3种诊断方案。绘制受试者工作特征性曲线(ROC)评估各个方案对CsPCa的诊断效能并统计诊断准确率,使用Z检验评估各方案之间的诊断效能是否有差异。结果在诊断CsPCa方面,基于S-PI-RADS评分标准的BpMRI评分得出的风险概率的诊断效能高于基于PI-RADS评分的BpMRI方案及相应得出的风险概率(Z=2.044,P=0.0410;Z=2.567,P=0.0103),同时基于S-PI-RADS评分标准的BpMRI评分得出的风险概率诊断CsPCa的诊断准确率有更进一步的提高。结论基于应用S-PI-RADS评分标准的BpMRI评分所得的风险计算器概率诊断CsPCa的诊断效能更高,且准确率更佳,是临床评估PCa更有价值的参考指标。

Objective To investigate the clinical value of prostate cancer(PCa)risk calculator when applying bi-parameter magnetic resonance imaging(BpMRI)in diagnosing clinically significant prostate cancer(CsPCa).Methods The clinical,pathological and multi-parameter magnetic resonance imaging(MpMRI)imaging data of 114 patients with prostate disease were retrospectively analyzed.Two radiologists firstly scored the MR images according to the MpMRI and BpMRI scoring schemes based on the prostate imaging reporting and data system(PI-RSAD)v2.1 scoring standard.And then,BpMRI scheme was scored based on simplified prostate imaging reporting and data system(S-PI-RADS)scoring standard.The scoring results of the three schemes were incorporated into the prostate cancer risk calculator to calculate the corresponding risk probabilities as the other three diagnostic schemes.Receiver operating characteristic curve(ROC)was drawn to evaluate the diagnostic efficacy of the schemes for CsPCa,and the diagnostic accuracies were counted.Z test was used to evaluate whether there were differences in the diagnostic efficacy of each scheme.Results In terms of diagnosing CsPCa,the diagnostic efficiency of risk probability obtained by BpMRI scoring based on S-PI-RADS scoring standard is higher than that of BpMRI scheme based on PI-RADS scoring standard and the corresponding risk probability(Z=2.044,P=0.0410;Z=2.567,P=0.0103).At the same time,the diagnostic accuracy of CsPCa detected by the risk probability obtained by BpMRI score based on S-PI-RADS scoring standard was better.Conclusion The risk probability caculated by prostate cancer risk calculator which using BpMRI scoring based on S-PI-RADS scoring standard has higher diagnostic efficiency and accuracy in detecting CsPCa,and is a more valuable reference index for clinical evaluation of PCa.